00040163 CITY 0Pe T W -N-t 1
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
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' BUILDING AU - 1•. t PERMIT NO. '
)WNL APPLICATION SUB DATE
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`PHONE: t' SANITARY NO. CONTROL NO
0 C Z ARCHITF,CUENGINELR i - J r
OO t ! i - - BUILDINGPERMITINTO
=. GRANNY UNIT: 640, EW, T: IV1,N_q 5F S0cE
Z y> I.ICENSI D CONT RA&OR S UI CLARATION
o Z_e fir by Irrt a t I' r .a.a dna i f co-pt 9 f nrneneng Job Description
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tW—a. OWNER BUILDER DECLARATION
�ZjQ fporIy'1 by.cf(lS t til7t UTI5 Bu.,'pt f dIll e Cf:ctrl t Cd I'AY L -I'rtl
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unty
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555 to t h I d p a th p c f tl C 1 1 L L ICI
to
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t„acme teind w m sr�nr,7wn)anile ra 3 ann,eas nes.' na Pror,.a r n,Code) S9• F., d _ `.'Valuation
or th lleLee pt theref Irl b 'r thc'llege4t Pt t AnYvfltnt �
or9 1 170315by pnY PPI anf-sp is bJ 'te the ppf: a ucivitl nnity 'p
.arnt mnf' n eredaalmsts5ao) - •AP mbar 'Occupancy�Type
!GR broP,ry nr n 'th - ' 10^c —. P PIERS t
r [th t Y p Y 'g th p t m, n
Willa m ade t t d l u do 1s 7o4a, 103, _ UFERquireitlnspections
Bu an I P t :. n C d The C i t L Lu J t pplY toort
r1 , yWhb Ids p . th d h I . . ch kI' If - 104 — REBAR •
n 11th hill, ply ..p Jath t. h np t nt t dd r yf,
offeredf 1rn d n 'ays p r t . . lahed ttbuildyear ,r 1.05" — ANCHOR BOLTS
C. 1I't to wnc h to lLh',c the harden of proving that he did I I . Id or `
anp t p pI ). r '.1.06 —' SEWER' R' WATER.. .
❑I rlh p p t70 Iy t r� , d t to
202 UNDERFLOOR PLUMBING -
ut- a p'j 't(S 91}148 . JP [ '. Cd )ed C tit
, La J otapply t n f p p tty. 'n b le improves d n 203 UNDERFLOOR MECHANICAL _ r
d aho contracts for such pr deck with a contractors)licensed 1 arswnt to h I
Contractors
o ''I L” - - 204UNDERFLOOR FRAME
."apt I,rs ` `
B��cf n . - 301 - ROUGH ' PLUMBING
Ow — ON
WE
RS COMPPNSA 110 CIARATION
C0S
' UNDERFLOOR -INSULATION
,
-`r'9 Inereby alio -dcv".Ity ,fp ri ryoncoftliciollowingdeclarnuonN' 3, G2 .-- TUBn I OR SHOWER C "b e
Cl I n dill dartard Ceribcore.orConsent to. lla f Wka a 303 — ROUGHMECHANICAL .
Co p Jtmn, as provided f ov Section 3700 at the
, if rhoCode, far the b
pernrne.off fthewakfir,which di.p t ;'sed 304ROUGH' ELECT RICAL -
❑I have oral ll on i ' Weaker',C p f ln; -t d red by Seniort' 305' FRAME , I ?
ofll ar the Labor Ckie,for,he performance of the work for which this partmt Is <
round.MyWorkers C tp ,satetm,arancecarrlcrazdolcyat,thcrare: 306 ' HOLDOWNS
Co . Pan ryNo 307 — !jNSULATION
CERT I FICXHON OF F,XEMPI'[ON FROM WORKERS"
COMPENSXHON INSURANCE - � 3Q18 . — SHEETROCK 't '• r '
(Thn,wctinremmtbew'npletdT@perndn,r - nentnd'edal ,�, - 309- - EXTERIOR ,LATH
Islool, Is) - 31.0' — INTERIOR LATH
shall that to forbearance nh sell,l h vn k p t , „ e 1 311 — SCRATCH COAT
�t G, p 1 ,ao y aerson
If n Y t c y ah) t�t�k hers , r
Appl t Ir'U `� dYAY• - 31.3' - ROOF NAIL
.NO'IICCT P C If ft L t'F t rL pt - Y ;n m - -501' FINAL ELECTRICAL" ENERGY
C 'clans,hbJe rt t k 't of tile Lb Cirri rotor
rarlhwthcmnply h ,rIisfrnt1. shnbcdemedrevnsedn _ 502 :'— FINAL PLUMBING F_NERGY.
y CONS rRUC NON LENDING AGENCY ^" n
E" that m Rag ase aYf d p,r , n ,., 503 -,= FINAL MECHANICAL ENERGY.
wathe ,.rkfor which tin
n ,I,kired(sc.,3097,Cie.c) 504 FINAL BUILDING ENERGY
vA Lender',Na ne ,'I
znae':Aadr.. r 505 — FINAL; ELECTRICAL.
. � I tryttrrin dhis'ppl t land state b habilitation - 50E - GAS "'TES'T
5'(~ car t f gra t ply tl aII D' I ty d d.t t I cl t g ' r- - '♦
o tab ld g rot dI hy'w p Iry Ito o nt p 5@7 'FINAL 'PLUMBING �< t
hen d l a, ndety p , ° , 508 ' F I NAL' MECHANICAL
'ter a e(We)add d 'ryand k PI I. IM1 I, fC p i 'g' t - •'
t+ y lablt jdgm t t J p c, 11 uy'nanY Y �ayar,tad -
v Z city e4UNDE ST foldingAND
Plant, 509 _ FINAL: GARDE,
�--t SO
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON POINT
SO certeru - Issued by:, ''iilh FPN411 PLANNING,'uDate', 4�
Ithe
eyt 92 TwLa ole — FINAL PUBLIC WORKS
tenattm I'ca t o Re-roofs . -
ZARDDUS MATERIALS DISCLOSURE. yp 602 ..ROOF PLYWOOD NAIL
Il Inca t I t bulla nB p' t score ur handle hranrdr aii m'Safety T e of Roof
asdt dbY lhcUpcn M -plCodc,Chtptcr912 and the Health and Safety N - '
Code s t 25532I) 603 —. .ROOF BATTENS "
1:11 vies �" All roots shall (50AAspectepQ10F•r tdi4tffk if Bial being mstallead:
Will the pyi ' f ' b id' g t p 'ay Area Air ' I h'rn 11'a roof is in withouthrsf obtainingan inspection, I a ree to remove
Eemitflotations am nsas ebroadedh...rtdic..ATOtalryManJswhichcareltall - P g _ 1
Dtaar,rr 'all new materials for inspection. Applicant;understands and`will'coinply,with;'�
oYe, �" - • all non-point source regulations. • a. -
i hJ I'tire hannolosts'aroarnaillsairearear,none,-Clroopt6.95 or the _
Calf Healdo&Saf tyCode Sedans 25505 25533 and 5534, d stntdthat r
ifnotify
th h Td' Joes not eurrcntl laveaten' t tk
g y tit''. yrap :lol'lyt na ay the _ •p,
occ I' t r IM1 q v r'coicM1 ousM1e t priort r C lifctc
- Y -
al111
r
Do, p r . id A00O Slgnatute of Applicant "': ' Date
OwneraRwr t,d end Da - All root coverings to be Class ;B ' or better '